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Evidence-based guidelines and secondary meta-analysis for the use of transcranial direct current stimulation in neurological and psychiatric disorders
- Source :
- Repositório Científico de Acesso Aberto de Portugal, Repositório Científico de Acesso Aberto de Portugal (RCAAP), instacron:RCAAP, International Journal of Neuropsychopharmacology
- Publication Year :
- 2020
- Publisher :
- Cambridge University Press, 2020.
-
Abstract
- Background Transcranial direct current stimulation has shown promising clinical results, leading to increased demand for an evidence-based review on its clinical effects. Objective We convened a team of transcranial direct current stimulation experts to conduct a systematic review of clinical trials with more than 1 session of stimulation testing: pain, Parkinson’s disease motor function and cognition, stroke motor function and language, epilepsy, major depressive disorder, obsessive compulsive disorder, Tourette syndrome, schizophrenia, and drug addiction. Methods Experts were asked to conduct this systematic review according to the search methodology from PRISMA guidelines. Recommendations on efficacy were categorized into Levels A (definitely effective), B (probably effective), C (possibly effective), or no recommendation. We assessed risk of bias for all included studies to confirm whether results were driven by potentially biased studies. Results Although most of the clinical trials have been designed as proof-of-concept trials, some of the indications analyzed in this review can be considered as definitely effective (Level A), such as depression, and probably effective (Level B), such as neuropathic pain, fibromyalgia, migraine, post-operative patient-controlled analgesia and pain, Parkinson’s disease (motor and cognition), stroke (motor), epilepsy, schizophrenia, and alcohol addiction. Assessment of bias showed that most of the studies had low risk of biases, and sensitivity analysis for bias did not change these results. Effect sizes vary from 0.01 to 0.70 and were significant in about 8 conditions, with the largest effect size being in postoperative acute pain and smaller in stroke motor recovery (nonsignificant when combined with robotic therapy). Conclusion All recommendations listed here are based on current published PubMed-indexed data. Despite high levels of evidence in some conditions, it must be underscored that effect sizes and duration of effects are often limited; thus, real clinical impact needs to be further determined with different study designs.
- Subjects :
- medicine.medical_specialty
Evidence-based medicine
AcademicSubjects/MED00415
medicine.medical_treatment
neurological disorders
Pain
Review
Transcranial Direct Current Stimulation
Tourette syndrome
tDCS
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Fibromyalgia
Clinical evidence
medicine
Humans
Pharmacology (medical)
Pharmacology
Brain Diseases
Evidence-Based Medicine
Transcranial direct-current stimulation
AcademicSubjects/SCI01870
business.industry
Mental Disorders
Clinical study design
medicine.disease
3. Good health
030227 psychiatry
Clinical trial
clinical evidence
Psychiatry and Mental health
psychiatric disorders
Schizophrenia
Meta-analysis
Practice Guidelines as Topic
Major depressive disorder
business
Psychiatric disorders
030217 neurology & neurosurgery
Neurological disorders
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Repositório Científico de Acesso Aberto de Portugal, Repositório Científico de Acesso Aberto de Portugal (RCAAP), instacron:RCAAP, International Journal of Neuropsychopharmacology
- Accession number :
- edsair.doi.dedup.....7a69cdd3fad001e63bcc1130a1b0bf02